Second hand tobacco smoke adversely affects the bone of immature rats

OBJECTIVES: To evaluate the influence of secondhand cigarette smoke exposure on longitudinal growth of the tibia of growing rats and some parameters of bone quality. METHODS: Forty female rats were randomly divided into four groups: control: rats were sham exposed; 30 days: rats were exposed to tobacco smoke for 30 days; 45 days: rats were exposed to tobacco smoke for 45 days; and 60 days: rats were exposed to tobacco smoke for 60 days. Blood samples were collected to evaluate the levels of cotinine and alkaline phosphatase. Both tibias were dissected and weighed; the lengths were measured, and the bones were then stored in a freezer for analysis of bone mineral content and mechanical resistance (maximal load and stiffness). RESULTS: Exposure of rats to tobacco smoke significantly compromised bone health, suggesting that the harmful effects may be time dependent. Harmful effects on bone growth were detected and were more pronounced at 60-day follow-ups with a 41.8% reduction in alkaline phosphatase levels (p<0.01) and a decrease of 11.25% in tibia length (p<0.001). Furthermore, a 41.5% decrease in bone mineral density was observed (p<0.001), leading to a 42.8% reduction in maximum strength (p<0.001) and a 56.7% reduction in stiffness (p<0.001). CONCLUSION: Second hand cigarette smoke exposure in rats affected bones that were weaker, deforming them and making them osteopenic. Additionally, the long bone was shorter, suggesting interference with growth. Such events seem to be related to time of exposure.

Estudo anatômico de bolsões adiposos na região hipogástrica / Anatomic study of pockets areas in the hypogastrium

INTRODUÇÃO: Nas lipodistrofias da parede abdominal anterior, fatores genéticos, aumento de peso, idade e lasseamento da musculatura, de forma isolada ou associada, determinam alterações estéticas generalizadas ou localizadas no epigástrio, no hipogástrio ou, mesmo, em ambas as regiões. O objetivo deste estudo é descrever os limites, a disposição, as relações anatômicas das bolsas adiposas no hipogástrio com as estruturas vizinhas e suas dimensões. MÉTODO: Foram dissecadas 57 peças anatômicas de pacientes submetidas a abdominoplastia, em que o hipogástrio foi ressecado em monobloco. Além disso, foi realizada dissecção da parede abdominal anterior em 8 cadáveres. Em todas as peças, a camada lamelar foi ressecada, mantendo-se a derme-epiderme, a camada areolar e a fáscia superficial íntegras. RESULTADOS: Em todas as peças, foram observados dois cúmulos adiposos na camada areolar bilateralmente, simétricos, em forma de bolsa e de coloração peculiar. Essas bolsas foram também analisadas em relação aos tecidos cutâneos vizinhos: pele, fáscia superficial, camada profunda de gordura. CONCLUSÕES: A camada lamelar foi considerada estrutural como base da pele, pela sua fina espessura, e a camada areolar apresentou acúmulos e volumes variáveis de tecido adiposo nas diversas regiões do corpo, sem limites precisos, particularmente observados nas dissecções da parede abdominal inferior, pela sua elasticidade, pelo volume e pela coloração.

BACKGROUND: In lipodystrophies of the anterior abdominal wall, variables such as genetic factors, weight gain, age, and loss of muscle tone, either alone or in combination, determine generalized aesthetic changes or changes localized in the epigastrium, hypogastrium, or both. The aim of this study was to describe the limits, distribution, and dimensions of fat bags in the hypogastrium, as well as their anatomic relationships with the neighboring structures. METHODS: Fifty-seven anatomical specimens were dissected from patients undergoing abdominoplasty, during which the hypogastrium was resected en bloc. Moreover, the anterior abdominal wall was also dissected in 8 cadavers. In all samples, the lamellar layer was resected, keeping the dermis-epidermis, areolar layer, and superficial fascia intact. RESULTS: In all specimens, 2 symmetrical adipose clusters were observed bilaterally in the areolar layer, which were in the shape of a bag and had peculiar coloration. These bags were analyzed in relation to their neighboring tissues: the skin, superficial fascia, and deep fat layer. CONCLUSIONS: The lamellar layer was considered as a structural base of the skin, owing to its thinness. The areolar layer showed accumulations and varying amounts of fat in the various body regions without precise limits, which were particularly observed in dissections of the lower abdominal wall and identified by their elasticity, volume, and coloration.

Atresia of the coronary sinus ostium to the right atrium with a persistent left superior vena cava / Atresia del ostium del seno coronario en el atrio derecho con una vena cava superior izquierda persistente

The coronary sinus has lately assumed an important role in the cardiologic clinic once it has been widely used in invasive procedures of the heart. Commonly, it is used during the electrodes implants for the epimiocardic monitoring of the cardiac rhythm, through a biventricular pace maker. These invasive procedures are not possible in hearts with an atresic coronary sinus ostium. In the presence of this anomaly, another may occur: the development of the "Marchal" vein which is a remaining of the left superior vena cava (LSVC). This happens so that the venous blood from the heart can drain into the right atrium, by a communication between the LSVC and the left brachiocephalic vein. The presence of a LSVC brings difficulties when performing an invasive procedure in order to access the right atrium through the superior vena cava, usually done in the cardiologic clinic. Moreover, the LSVC crossing over the left atrium is vulnerable to cardiovascular surgical interventions, confirmed by clinical reports. In the present study, 400 formalin fixed hearts from male cadavers, aged between 35 and 80 years, were investigated, particularly for the anatomy of the coronary sinus. The obliterated ostium of the coronary sinus to the right atrium associated with a persistent LSVC was present in only one (0.25 percent). We performed a diameter study of these structures since they were dilated due to the venous blood from the heart draining into the right atrium, by a communication between the LSVC and the left brachiocephalic vein. We also perform a literature review of these cases and discuss our finding in relation to its clinical importance.

El seno coronario recientemente ha asumido un papel importante en la clínica cardiológico, siendo ampliamente utilizado en procedimientos invasivos del corazón. Comúnmente, se utiliza en los implantes de los electrodos para el monitoreo epimiocárdico del ritmo cardiaco, a través de un ritmo biventricular establecido. Estos procedimientos invasivos no son posibles en los corazones con una atresia del ostium del seno coronario. En presencia de esta condición, se puede producir otra anomalía: el desarrollo de la vena de "Marchal" la cual es un vestigio de la vena cava superior izquierda (VCSI). Esto provoca que la sangre venosa del corazón pueda drenar en el atrio derecho, por una comunicación entre la VCSI y la vena braquicefálica izquierda. La presencia de una VCSI trae dificultades a la hora de realizar un procedimiento invasivo con el fin de acceder al atrio derecho a través de la vena cava superior, usualmente hecho en la clínica cardiológica. Por otra parte, el cruzamiento de la VCSI sobre el atrio izquierdo es vulnerable en las intervenciones quirúrgicas cardiovasculares, confirmado por informes clínicos. En el presente estudio, 400 corazones fijados en formalina provenientes a cadáveres de sexo masculino, con edades comprendidas entre los 35 y 80 años, fueron investigados, en particular por la anatomía del seno coronario. El ostium obliterado del seno coronario al atrio derecho asociado con una VCSI persistente estuvo presente en sólo una muestra (0,25 por ciento). Se realizó un estudio del diámetro de estas estructuras dilatadas debido a que la sangre venosa drena desde el corazón hacia el atrio derecho, por una comunicación entre la VCSI y la vena braquicefálica izquierda. También se realiza una revisión de la literatura de estos casos y se discuten nuestros hallazgos en relación con su importancia clínica.

Common carotid artery bifurcation levels related to clinical relevant anatomical landmarks / Niveles de Bifurcación de la Arteria Carótida Común en Relación a Puntos de Referencia Anatómicos Relevantes en Clínica

En cirugías de cabeza y cuello, las arterias carótidas comunes son importantes puntos de referencia, para defnir el plano de disección, durante cirugías radicales de cuello. Los objetivos del presente estudio fueron agregar información sobre el diámetro de las arterias carótidas y correlacionar el nivel de bifurcación de la arteria carótida común (ACC) con importantes puntos de referencia usados regularmente en la práctica clínica. Para la obtención de los objetivos planteados, fueron evaluados 46 cadáveres formolizados de individuos de sexo masculino. Se obtuvieron los diámetros de las arterias carótidas común, externa (ACE) e interna (ACI), con el auxilio de un caliper digital. No hubo diferencias entre lados derecho e izquierdo, ni tampoco en los niveles estudiados. El nivel de bifurcación de la ACC fue medido en relación a puntos de reparos anatómicos relevantes en clínica (margen superior del cartílago tiroides, ángulo de la mandíbula y lóbulo del pabellón auricular), como también en relación al nivel vertebral. Nuestro estudio mostró que el margen superior del cartílago tiroides fue el punto de referencia más estable para inferir el nivel de bifurcación de la ACC. Es importante mencionar que, de todos los puntos de referencia estudiados, la vértebra cervical fue la única que mostró diferencias entre los lados, siendo más variable el nivel de bifurcación en el lado izquierdo.

In head and neck surgery, the common carotid arteries are important landmarks, defining dissection plane during radical neck surgeries. The objectives of the present study were to add information on the diameter of the carotid arteries and to correlate the common carotid artery (CCA) bifurcation level with important anatomical landmarks used regularly in clinical practice. Forty-six necks from male embalmed human cadavers were evaluated. The CCA as the external (ECA) and internal (ICA) carotid arteries diameters were studied with the aid of an electronic digital caliper. No differences were found between sides in any level studied. The CCA bifurcation level was measured in relation to clinically relevant anatomical landmarks (superior level of the thyroid cartilage, mandible angle and ear lobe) and the bifurcation level according to the cervical vertebra level was also investigated. Our study shows that the superior border of the thyroid cartilage was the most stable anatomical landmark for predicting the CCA bifurcation level. It is important to mention that from all the landmarks studied, the cervical vertebra was the only one to show differences between sides, with the left side bifurcation level more variable than the right side.

A cineangiocoronariographical study of the irrigation of the sinuatrial node and perinodal area in human hearts

Since the initial description of the sinuatrial node and its vascularization, numerous studies have shown the importance of the sinuatrial nodal branch (SNA). In this work, we examined the anatomy of this atrial branch using cineangiography. We reviewed the records of 100 cineangiocoronariographies done between October 1991 and November 1992 in the teaching hospital of the Faculty of Medicine of Triângulo Mineiro. The records of patients with artificial pacemakers or who had undergone cardiac surgery were not included. All the records showed left anterior oblique and right anterior oblique projections of both coronary arteries. In 65 por cento of the cases, the SNA occurred as a branch of the right coronary artery, and in 33 por cento it derived from the left coronary artery. Double irrigation of the sinuatrial area was seen in 1 por cento of the cases, and in 1 por cento of the cases the SNA originated from the aorta. In 76.9 por cento of the cases, the branch was of the medial anterior type and became less frequent in the distal part of the coronaries. There were no significant sex-related (χ2 = 0.0092), or racial (χ2 = 0.1241) differences. These finding were similar to those of studies based on anatomical or angiographic approaches. We conclude that the SNA can arise from any coronary artery, with no single, specific origin, and that there are no gender or race-related differences in this pattern.